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[头痛新闻]

[Headache News].

作者信息

Diener Hans-Christoph, Gaul Charly, Holle-Lee Dagny, Lazaridis Lazaros, Nägel Steffen, Obermann Mark

出版信息

Fortschr Neurol Psychiatr. 2017 Jun;85(6):352-365. doi: 10.1055/s-0043-111118. Epub 2017 Jun 23.

Abstract

A review of the latest and most relevant information on different disorders of head and facial pain is presented. News from epidemiologic studies regarding the relationship between migraine and patent foramen ovale, the cardiovascular risk in migraine, and migraine behavior during menopause, and the development of white matter lesions or migraine genetics are presented. Regarding pathophysiology there are very recent insights regarding the role of the hypothalamus during prodromal phase and the interplay of brain-stem and hypothalamus during the attack. In the last year studies and metaanalysis generated new knowledge for the use of triptans in general as in menstrual related migraine and hemiplegic variants. Furthermore, new hope rises for the CGRP (calcitonin-gene related peptide)-antagonists, as the data for ubrogepant do not suggest hepatotoxicity but efficacy. In prophylactic migraine treatment the news are manly on how the new therapeutic approach with monoclonal antibodies against CGRP or its receptor is moving on. Additional newly generated data for already known prophylactic agents as for new approaches are compactly discussed. Although main developments in headache focus on migraine new data on trigemino-autonomic headache trigeminal neuralgia and new daily persistant headache became available.

摘要

本文综述了关于头面部疼痛不同病症的最新及最相关信息。介绍了流行病学研究中有关偏头痛与卵圆孔未闭的关系、偏头痛中的心血管风险、绝经期间的偏头痛表现,以及白质病变的发展或偏头痛遗传学方面的消息。在病理生理学方面,最近有关于下丘脑在先兆期的作用以及发作期间脑干与下丘脑相互作用的新见解。去年的研究和荟萃分析为曲坦类药物在一般情况下以及与月经相关偏头痛和偏瘫型偏头痛中的应用产生了新知识。此外,降钙素基因相关肽(CGRP)拮抗剂带来了新希望,因为ubrogepant的数据未显示肝毒性但具有疗效。在偏头痛预防性治疗方面,主要消息是针对CGRP或其受体的单克隆抗体新治疗方法的进展情况。还简要讨论了已知预防性药物的新生成数据以及新方法。尽管头痛方面的主要进展集中在偏头痛,但关于三叉神经自主性头痛、三叉神经痛和新的慢性每日头痛也有了新数据。

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